Fully Guided Zygomatic Implant Surgery

Rigo, Leone; Tollardo, James; Giammarinaro, Enrica; Covani, Ugo; Caso, Guerino

doi:10.1097/scs.0000000000008005

Cited by 6 publications

(10 citation statements)

References 19 publications

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“…This could indicate that even when executed by experienced surgeons, there is a frequent occurrence of suboptimal zygomatic implant positioning using a free-hand placement. The concept of guided zygomatic implant placement was first tested by our group in a series of human cadavers [12]. The data of this pre-clinical cadaver study and the data presented here are comparable in accuracy.…”

Section: Discussionmentioning

confidence: 51%

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Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Vosselman

Glas

Merema

et al. 2022

JPM

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Zygomatic implants are used in patients with maxillary defects to improve the retention and stability of obturator prostheses, thereby securing good oral function. Prosthetic-driven placement of zygomatic implants is even difficult for experienced surgeons, and with a free-hand approach, deviation from the preplanned implant positions is inevitable, thereby impeding immediate implant-retained obturation. A novel, digitalized workflow of surgical planning was used in 10 patients. Maxillectomy was performed with 3D-printed cutting, and drill guides were used for subsequent placement of zygomatic implants with immediate placement of implant-retained obturator prosthesis. The outcome parameters were the accuracy of implant positioning and the prosthetic fit of the obturator prosthesis in this one-stage procedure. Zygomatic implants (n = 28) were placed with good accuracy (mean deviation 1.73 ± 0.57 mm and 2.97 ± 1.38° 3D angle deviation), and in all cases, the obturator prosthesis fitted as pre-operatively planned. The 3D accuracy of the abutment positions was 1.58 ± 1.66 mm. The accuracy of the abutment position in the occlusal plane was 2.21 ± 1.33 mm, with a height accuracy of 1.32 ± 1.57 mm. This feasibility study shows that the application of these novel designed 3D-printed surgical guides results in predictable zygomatic implant placement and provides the possibility of immediate prosthetic rehabilitation in head and neck oncology patients after maxillectomy.

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Section: Discussionmentioning

confidence: 51%

“…The drill guide for zygomatic implant placement, introduced by Vrielink et al [11] in 2003, which was solely based on available bone volume, unfortunately had an unfavorable accuracy. A technical note describing guided placement of zygomatic implants in atrophic maxillae lacks implant placement-accuracy analysis [12].…”

Section: Introductionmentioning

confidence: 99%

Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Vosselman

Glas

Merema

et al. 2022

JPM

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“…Some studies have extended clinical understanding to show the success rate of ZI [1][2][3][4][34][35][36]. Thus, the study evaluated the anatomical factors that influence the virtual planning of ZI using cone-beam computed tomography scans were performed on 268 maxillary edentulous patients.…”

Section: Major Clinical Results Of the Virtual Zygomatic Implants (N=...mentioning

confidence: 99%

“…In the context of implantology and severe resorption, zygomatic implants (ZI) are indicated and the procedures can be completed with the positioning of a custom-made provisional prosthesis, reducing surgical time and optimizing results [1]. One of the main reasons for the use of ZI is due to the lack of bone in the alveolar crest due to dentoalveolar trauma, traumatic extractions and pathologies such as cancer [2,3].…”

Section: Introductionmentioning

confidence: 99%

Major clinical results of virtual zygomatic implant and assessment of the risk of bias: a systematic review

Furtado¹,

Martin²,

Manzini³

2022

MedNEXT

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Introduction: In the context of implantology and severe resorption, zygomatic implants (ZI) are indicated and the procedures can be completed with the placement of a custom-made provisional prosthesis, reducing surgical time and optimizing results. Digital (virtual) optimizations for the ZI were developed in computerized radiology machines that allowed improvements in diagnostic and therapeutic tools. Objective: It was carried out a systematic review of the main considerations and clinical outcomes of using digital tools for the optimization of the virtual zygomatic implant. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from January 2022 to April 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 94 articles were found. In total, 62 articles were fully evaluated and 41 were included and evaluated in this study, and of the total of 41 articles, only 14 articles were developed as the main clinical results of the virtual zygomatic implant. Reducing errors and complications is essential if zygomatic implants are to remain a viable treatment alternative, and further research on a guided approach to their placement is encouraged. The surgical guide system showed accuracy for all variables studied and allowed acceptable and accurate implant placement, regardless of the complexity of the case. Thus, the surgical and prosthetic plan, the position, the emergence, the shape of the implants, the position of the provisional prosthesis, the inter-arch relationships, and the surgical templates were designed in a virtual environment and previously performed by the surgeon in stereolithographic models, allowing the surgical procedure was significantly simplified.

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“…This method can reduce surgery time, simplify the procedure and optimize the result. Thus, 19 of the 20 patients included in the study had successful implants and prostheses at the time of analysis [31].…”

Section: Summary Of Findingsmentioning

confidence: 99%

Major indications and current clinical findings of zygomatic implant: a systematic review

Neto

Sousa

Manzini

2022

MedNEXT

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Introduction: The lack of bone in the alveolar crest represents a major problem in aesthetic recovery in patients who have suffered dentoalveolar trauma, traumatic extractions, congenital tooth absence pathologies involving maxilla and mandible, and the possibility of deformity. In this sense, the zygomatic implant (ZI) is an alternative when there is bone loss. Objective: It was to carry out a systematic review of the main clinical outcomes of ZI, emphasizing the main indications. Methods: The present study followed the PRISMA rules. The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases, following the rules of the word PICOS (Patient; Intervention; Control; Outcomes; Study Design). The Cochrane Instrument was used to assess the risk of bias of the included studies. Results and Conclusion: A total of 82 articles were found involving zygomatic implantation and the evolution of the technique. Initially, the duplication of articles was excluded. A total of 54 articles were fully evaluated and 33 were included in this study. Based on the clinical results of the last five years, some studies have broadened clinical understanding based on comparative studies to show the success rate of ZI. Even if more complications were reported for ZI that resolved spontaneously or could be handled, ZI proved to be a better modality of rehabilitation for severely atrophic jaws. Furthermore, zygomatic surgery proved to be a viable and safe alternative to conventional treatment modalities for oral rehabilitation of patients with ectodermal dysplasia syndrome. Also, there was greater accuracy and drastically reduced risk of perioperative/postoperative complications using the dynamic navigation system compared to the freehand placement of implants. Finally, guided surgery for the placement of ZI using specially designed metal jigs that must be supported by bone showed the placement of a made-to-measure provisional prosthesis, reducing surgery time, simplifying the procedure, and optimizing the result.

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Fully Guided Zygomatic Implant Surgery

Cited by 6 publications

References 19 publications

Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Three-Dimensional Guided Zygomatic Implant Placement after Maxillectomy

Major clinical results of virtual zygomatic implant and assessment of the risk of bias: a systematic review

Major indications and current clinical findings of zygomatic implant: a systematic review

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